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SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections

The Skeptics' Guide to EM

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

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EM Journal Update: Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma

Core EM

A narrow pulse pressure has been shown to predict the need for hemorrhage control in the ED setting but has not been assessed as a predictor in the prehospital setting. A narrow pulse pressure occurs due to compensatory increased systemic vascular resistance in the setting of decreased cardiac output.

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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. He reports distension and the sensation of fullness. Small bowel dilation may also be seen.

E-9-1-1 78
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SGEM#205: Twist & Shout – Testicular Torsion

The Skeptics' Guide to EM

In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. AEM Dec 2017.

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Cervical Spine Imaging in Kids – the PECARN rule

Don't Forget the Bubbles

Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. A proportion of participants were missed because the ED provider refused enrollment or said “Other,” but this is not well described. What is the problem? What were the results?

CPR 124
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Episode 35: When to operate in trauma with Dennis Kim

Critical Care Scenarios

Takeaway lessons * Trauma patients who are hypotensive or otherwise unstable should be assumed to be bleeding, bleeding, bleeding until proven otherwise, and should have a very low threshold to proceed directly to the operating room for exploration.* Operative prep for exploratory laparotomy is usually from the chin to the knees.

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Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚

ED 54